Three years' interventional neurology experience in Turkey with the Thrombite thrombectomy device in large vessel occlusion in the anterior circulation: safety, efficacy, and clinical outcome.

Introduction: While the Thrombite device differs from the Solitare stent with its Helical open-side structure feature, it shows great similarity with its other features. We assessed the Thrombite device's effectiveness and safety in this study. Materials and methods: The study was a retrospective analysis of patients who were included in the Turkish Interventional Neurology database and who had mechanical thrombectomy with the Thrombite device as the first choice between January 2020 and January 2023. The type of study is descriptive research. Result: Using the Thrombite thrombectomy device, 525 patients received treatment. The median baseline National Institutes of Health Stroke Scale (NIHSS) score was 13, the median initial Alberta Stroke Program Early Computed Tomography (ASPECT) score was 8, and the mean patient age was 68.6+11.7 years. Between the groin puncture and the successful recanalization, the median time was 34 minutes (interquartile range [IQR]: 15-45). 48.2% (modified treatment in cerebral infarction; mTICI) 2b/3% and 33.9% (mTICI 2c/3) were the first-pass recanalization rates. In the end, 87.7% of patients had effective recanalization (thrombolysis in cerebral infarction 2b/3). In the "first-pass" subgroup, the favorable functional result (modified Rankin Scale 0-2) was 51.8%, while it was 41.6% for the entire patient population. The rate of embolization into new territory/different territory were 2.1/0.1%. 23 patients (4.5%) had symptomatic hemorrhage. Conclusion: The Thrombite device showed a good safety profile and high overall successful recanalization rates in our experience.

Bacteria Found in Brasswind Instruments: Analyses Using Culture-Dependent Method and Culture-Independent 16 S rRNA Amplicon Sequencing Method.

BACKGROUND: In wind instrument performance, there is a constant contact between the player and the instrument, during which microorganisms in the mouth flora of the player are transferred into the instrument. The inner surface of the brass instruments provides the perfect environment for microorganisms to grow. As a result, players repeatedly interact with these micro-organisms during playing. In previous studies, different kinds of microorganisms were detected in brass instruments, some of which can carry serious health hazards. PURPOSE: Revealing the common bacterial populations of brasswind instruments will be helpful in raising awareness among musicians and establishing their habits of cleaning/disinfecting their instruments. METHODS: In this study, samples from 4 different areas of 14 brass instruments were collected and analyzed using culture-dependent and -independent (16 S rRNA amplicon sequencing) approaches. The bacterial loads in different parts of the instruments were compared. RESULTS: The amount and variety of bacteria detected in the sampled instruments were unexpectedly large. While some of the found bacteria are harmless, others, such as Chryseobacterium and Elizabethkingia, may occasionally cause serious infections, especially in people with suppressed immune systems. Likewise, the Mycobacterium group includes a type that causes tuberculosis, and the Streptococcus group also shows pathogenic characteristics. The mouthpiece and leadpipe of the instruments had a much larger microbial load compared to the tuning and valve slides. CONCLUSION: According to the findings, brass instruments may harbor a wide variety of bacteria, some of which are potentially hazardous for the musicians' health, especially if their immune systems are compromised. These risks can be minimized by regularly cleaning and disinfecting the instrument, especially the mouthpiece and leadpipe, which are the areas harboring most of the microorganisms.

Comparison of the Effects of COVID-19 Pandemic on Male and Female Gender in Patients Diagnosed with Idiopathic Parkinson's Disease: A Case of Sakarya Province, Turkey.

Introduction: The study aims to evaluate the motor, non-motor, cognitive and psychiatric conditions of our patients diagnosed with Idiopathic Parkinson's Disease (IPD) before and after the COVID-19 pandemic and to investigate the effect of the pandemic on male and female genders. Methods: Ninety patients were included in the study. Demographic data such as age, gender, and duration of disease, type of disease of the patients were recorded. Patients were then divided into 2 groups: male and female. Movement disorders of both groups before the pandemic, disease stage determined by H&Y and UPDRS at the admission and after the pandemic, Levodopa equivalent dose used were recorded and all patients were surveyed to evaluate their motor, non-motor, cognitive, and psychiatric conditions during the COVID-19 pandemic. The effects of the COVID-19 pandemic on male and female genders were investigated. Results: Of the patients, 40 were male and 50 were female. Daytime drowsiness, weakness, impaired walking, constipation, sleep disorders, and inability to turn in the bed worsened compared to the period before the pandemic. Yet, of the psychiatric symptoms, boredom, unhappiness, anhedonia, irritability, and tension were found to increase during the pandemic. There was a statistically significant difference in UPDRS, H&Y and disease stages before and after the COVID-19 pandemic in both groups, especially in the female group (p<0.05). Conclusion: Although it was more pronounced in female patients with IPD diagnosis, both motor and non-motor symptoms were found to worsen during the COVID-19 pandemic in both groups.

Optic Neuritis due to Use of Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide: A Case Report.

Neuroophthalmic involvement may occur in people infected with primary human immunodeficiency virus (HIV) due to the infection itself, opportunistic infections, malignancy or due to vascular causes. However, treatment-related optic neuropathy may be considered in patients receiving Antiretroviral therapy (ART), without an identified etiological cause, despite all examinations. In this case report, a near-complete recovery was observed in vision loss of a patient, whose 4-month treatment regimen of elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/FTC/TAF) was replaced with a combination of tenofovir disoproxil + emtricitabine and lopinavir+ritonavir due to the development of optic neuritis. Recognition of the present symptoms rapidly and the implementation of the necessary change is extremely important for preventing permanent damage in these patients.

Cervical vestibular evoked myogenic potentials and video head impulse test studies: alternative methods for detecting brainstem involvement in multiple sclerosis.

BACKGROUND: Brainstem involvement (BSI) has been reported as a major predictive factor for future disability in Multiple Sclerosis (MS). AIMS/OBJECTIVES: To evaluate whether Cervical Vestibular Evoked Myogenic Potentials (cVEMPs) and Video Head Impulse Test (vHIT) can be used to detect demyelinating lesions in vestibular pathways in MS. MATERIAL AND METHODS: Fifty three people with MS and 40 controls were evaluated with Dizziness Handicap Inventory (DHI), vHIT and cVEMP. RESULTS: The median value of DHI in MS group was significantly higher than controls (p<.001). According to vHIT results, while the results of horizontal canal vestibulo-ocular reflex gain in group with brain stem involvement (gBSI (+)) were significantly different from both controls and group without brain stem involvement (gBSI (-)) (p= .036 and .024, respectively), results of gBSI (-) were similar with controls (p= .858). When cVEMP results were examined, mean P1 wave latency in gBSI (+) was significantly longer than controls (p= .002), but difference between gBSI (-) and controls and gBSI (+) was not statistically significant (p= .104 and .279, respectively). CONCLUSIONS AND SIGNIFICANCE: vHIT and cVEMP can be used in diagnosis and follow-up of people with MS without demyelinating brainstem lesions on MRI.

The Role of De Ritis Ratio as a Clinical Prognostic Parameter in COVID 19 Patients.

BACKGROUND: The study aims to investigate whether the De Ritis ratio can also be used in patients diagnosed with COVID-19 as a follow-up parameter, such as NLR, which is used in the follow-up and treatment of many diseases. METHODS: Ninety-nine patients admitted to our hospital with suspected COVID-19 were included in the study. Demographic data of the patients, their history characteristics, presenting symptoms, filiation status, duration of clinical stay, and length of stay in intensive care unit, intubation, dialysis, and plasmapheresis needs were examined. The patients were divided into two groups: PCR positive and PCR negative. The presenting, 5th day, and the clinical discharge values of AST, ALT, LDH, urea, creatine, eGFR, De Ritis ratio, procalcitonin, CRP, WBC, NLR, ferritin, lymphocyte, and D-dimer levels of the patients in both groups were studied. RESULTS: The DM and CAD presence in the histories of PCR-positive patients was found to be statistically signifi-cantly higher (p = 0.05, p = 0.03, respectively). Presenting symptoms of headache, fatigue, gastrointestinal symptoms, and taste loss were significantly higher in the PCR-positive patients (p = 0.04, p = 0.02, p = 0.03, p = 0.02, respectively). In the PCR-positive patients, a statistically significant correlation was found between the presenting De Ritis ratios and the presenting NLR, 5th day NLR, and NLR at discharge (p = 0.007, p = 0.02, p = 0.015, respectively). In the PCR-positive group, the 1st and 5th day De Ritis ratios of females were statistically significantly higher than males (p = 0.000, p = 0.006, respectively). Albumin, procalcitonin, length of stay in intensive care unit were significantly higher in the PCR-positive patients, while the presenting D-dimer, presenting WBC, and presenting and 5th day lymphocyte values were significantly higher in the PCR-negative patients. CONCLUSIONS: These findings show that the De Ritis ratios can be used in PCR-positive patients as a parameter, such as NLR, to follow-up and determine the prognosis of many diseases.

Demographic characteristics and neurological comorbidity of patients with COVID-19.

ABSTRACT: The COVID-19 infection that started in the Wuhan Province of the People's Republic of China and has now spread throughout the world is not limited to the respiratory system, but also causes other systemic symptoms through viremia. Recent data show that the central and peripheral nervous system involvement is particularly substantial. Thus, the present study aims to investigate the current neurological comorbidities and symptoms of patients with COVID-19 who were followed up by our clinic physicians.

Demographic characteristics and neurological comorbidity of patients with COVID-19

SUMMARY ABSTRACT The COVID-19 infection that started in the Wuhan Province of the People's Republic of China and has now spread throughout the world is not limited to the respiratory system, but also causes other systemic symptoms through viremia. Recent data show that the central and peripheral nervous system involvement is particularly substantial. Thus, the present study aims to investigate the current neurological comorbidities and symptoms of patients with COVID-19 who were followed up by our clinic physicians.

RESUMO RESUMO A infecção de COVID-19 que começou na província de Wuhan, na República Popular da China, e já se espalhou por todo o mundo não se limita ao sistema respiratório, mas também causa outros sintomas sistêmicos através de viremia. Dados recentes mostram que seus efeitos no sistema nervoso central e periférico são particularmente significativos. Assim, o presente estudo tem como objetivo investigar as atuais comorbidades e sintomas neurológicos de pacientes com COVID-19 que foram acompanhados pelos médicos da nossa clínica.